Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers to refer potential candidates for Post-Acute Care services to facilitate early ...
Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers to refer potential candidates for Post-Acute Care services to facilitate early ...
Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers to refer potential candidates for Post-Acute Care services to facilitate early ...
Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers to refer potential candidates for Post-Acute Care services to facilitate early ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
This role will review patient medical records to ensure accurate documentation, proper level of ... utilization review, or CDI, in the acute care setting. * Knowledge of ICD-10 coding guidelines ...
In addition the position provides case review information to third party payers, assists in the ... Utilization Management analyzes and trends information and data in order to optimize efficiency of ...
In addition the position provides case review information to third party payers, assists in the ... Utilization Management analyzes and trends information and data in order to optimize efficiency of ...
Registered Nurse, Utilization Mgmt
Dayton, OH · On-site +1
$76K - $163K/yr
The Utilization Management (UM) RN demonstrates a high level of clinical practice, knowledge, and ... As a clinical reviewer he/she serves as the QM liaison creating effective lines of communication ...
Registered Nurse, Utilization Mgmt
Dayton, OH · On-site +1
$76K - $163K/yr
The Utilization Management (UM) RN demonstrates a high level of clinical practice, knowledge, and ... As a clinical reviewer he/she serves as the QM liaison creating effective lines of communication ...
Utilization Management Clinical Specialist
Columbus, OH · On-site
$72K - $88K/yr
This role functions as a clinical decision support partner, working across clinical, supervisory, and revenue cycle teams to monitor service utilization, conduct medical necessity reviews, and ...
Quick apply
Utilization Management Clinical Specialist
Columbus, OH · On-site
$72K - $88K/yr
This role functions as a clinical decision support partner, working across clinical, supervisory, and revenue cycle teams to monitor service utilization, conduct medical necessity reviews, and ...
Utilization Management Rep I
Mason, OH · On-site
Utilization Management Rep I Utilization Management RepresentativeI Virtual: This role enables ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Mason, OH · On-site
Utilization Management Rep I Utilization Management RepresentativeI Virtual: This role enables ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management RepresentativeI Virtual: This role enables associates to work virtually ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management RepresentativeI Virtual: This role enables associates to work virtually ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Dayton, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Dayton, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Akron, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Akron, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbus, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbus, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Dayton, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Dayton, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbus, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbus, OH · Remote
$29.05 - $67.97/hr
Job Qualifications REQUIRED QUALIFICATIONS: • At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical ...
New
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cincinnati, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Weekend Utilization Review information
See Ohio salary details
$20.34 - $24.45
2% of jobs
$24.45 - $28.57
9% of jobs
$31.38 is the 25th percentile. Wages below this are outliers.
$28.57 - $32.68
21% of jobs
The median wage is $36.01 / hr.
$32.68 - $36.79
23% of jobs
$36.79 - $40.91
13% of jobs
$44.11 is the 75th percentile. Wages above this are outliers.
$40.91 - $45.02
10% of jobs
$45.02 - $49.13
8% of jobs
$49.13 - $53.25
5% of jobs
$53.25 - $57.36
5% of jobs
$57.36 - $61.48
2% of jobs
$61.48 - $65.59
2% of jobs
$20
$40
$65
How much do weekend utilization review jobs pay per hour?
What does a typical weekend shift look like for a Utilization Review professional?
Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
What is a Weekend Utilization Review job?
A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.
What are the key skills and qualifications needed to thrive in the Weekend Utilization Review position, and why are they important?
Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.
- Hourly Interqual
- Remote Cigna Utilization Review Nurse
- Remote Navihealth Utilization Review
- Utilization Review Clinician Salary
- Remote Insurance Utilization Review
- From Home International Utilization Review Nurse
- Utilization Review Manager
- Live In Cigna Utilization Review Nurse
- Remote Utilization Review
- Temporary Aetna Utilization Review Nurse
Holzer Health System rating
6.3
Based on 36 frontline employees who took The Breakroom Quiz
632nd of 872 rated healthcare providers
Job description
Works under the supervision of the Director of Care Management. Reviews the medical record on a concurrent basis, utilizing criteria accepted and approved by the Medical Staff, for admissions and continued stay of patients requiring acute care or observation. Monitors the plan of care to ensure the efficient utilization of resources. Collaborates with the multidisciplinary team to improve clinical care, customer satisfaction, organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers to refer potential candidates for Post-Acute Care services to facilitate early discharge planning and transitions of care. Responsible for reviewing hospital patient account for correct status and billing compliance. Assists with Performance Improvement monitoring and reporting activities. Performs other duties as assigned.
Education, Work Experience and Licensure:
· Graduate of an accredited School of Nursing. BSN preferred.
· Active RN license recognized by the Ohio Board of Nursing.
· A minimum of three years experience as a registered nurse in acute care for adult or pediatric patients required. Past Hospital experience in related field will be taken into consideration.
· Professional experience with case management, utilization review, or discharge planning highly desirable.
· Certification/Accreditation in Case Management required within 2 years of eligibility.
What Holzer Health System employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Holzer Health System
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Gallipolis, OH, US
Year founded
1909